Drug addiction is a devastating force that tears lives and families apart, and slowly kills the addicted person. The person using drugs experiences a great deal of emotional and physical pain, and sometimes this pain can be so severe that it will push the addict to do things that will damage him and others. The family and loved ones are put through similar emotional pain. We at joe’s addiction are no exception to this and try to do everything to help this person overcome their drug addiction.
When promises to sober up failed, when the family abandoned the addicted or is left, and the finances drained, and when the addicted stand helplessly as dreams are shattered and the life of the addict slowly slipped away. Sometimes you wish you could just open the door and shove them through “helping” them walk away from it all.
We do try and help. Here at Joe’s Addiction “help” can be defined as to give aid, be of service, provide support, to relieve, and to prevent.
For many individuals who walk through our doors, substance abuse and homelessness are inextricably intertwined. Indeed, substance use is often both a precipitating factor and a consequence of being homeless. Individuals who are homeless rarely have substance use disorders alone—many have serious mental illnesses, acute and chronic physical health problems, and histories of trauma. They require a safe place, and we try to be that for them.
Mental Illness, Substance Abuse, and Homelessness
An estimated 50 percent of homeless adults with serious mental illnesses have a co-occurring substance use disorder. Individuals with co-occurring disorders have more problems, need more help, and are more likely to remain homeless than other groups of people.
Homeless people with mental and substance use disorders often have significant acute and chronic medical conditions, including diabetes, liver disease, upper respiratory infections, serious dental health problems, tuberculosis, and AIDS. Homeless individuals with alcohol disorders are in especially poor health.
People with substance use disorders who are homeless are more likely to have arrest histories, to have been arrested in the past year, and to report felony drug convictions. Fifty percent of all arrests of homeless people relate to drinking in public spaces.
Homeless people with substance use disorders, especially those with co-occurring mental disorders, are at risk of losing their future housing due to eviction, arrest, and incarceration. Once homeless, they are unlikely to succeed in treatment without access to safe, sober housing.
Fewer than one-quarter of individuals who need treatment for alcoholism or the use of illicit drugs receive it. Those with the least resources face the most significant barriers to care.
There is often a discrepancy between what homeless individuals want and what providers believe they need. Homeless individuals may urgently want a job, housing, and help with housing expenses. Only 9 percent of homeless respondents to a national survey mentioned alcohol and drug treatment as something they needed “right now.”
Luther
Luther is a very big, very beautiful, African American man who comes to Friday night open mic nights at Joe’s Addiction. He towers over everyone and his bright, smiling eyes glow, set against his dark black skin. His smooth voice melts souls. Having grown up in a southern black church, he loves to sing gospel music. Luther asks if he can sing in the band on Sundays, and we give him the opportunity.
Crack Cocaine
Luther has spent many years in prison for armed robbery and drugs. His drug of choice is crack cocaine. In prison, he stayed clean. He exercised, built his muscles, and his focus, and he gained a reputation as a “good guy.” He has a winning smile, and the other guys followed his charismatic leadership. I’m sure his size has something to do with his influence as well.
He gets a job soon after he is released, makes monthly payments on his fines, and meets responsibilities. Though life after prison is difficult, Luther seems to have the determination it takes to make it on the outside. He works hard. We see him as an example to others and mark him in our minds as leadership potential.
About six months into our relationship with him, on a cold afternoon in December, Luther shows up at Joe’s high. He is pacing and ranting words I can’t understand. Sweating profusely, big drops run off his face. Sweat has drenched his shirt. He walks in the door and then turns right around and goes back out. He paces the sidewalk, looking up and down the street, paranoid as though someone is after him.
I go to him and ask if I can help. “Is there anything I can do?” He looks at me, eyes piercing, and says, “No, sister. I fucked up. I just fucked up.” A few regulars sit drinking coffee and playing cards. They don’t need me, so for a while, I join Luther’s pacing, trying to keep stride alongside him. He talks and talks, but he isn’t making much sense except to say again and again, “I fucked up. I fucked up.”
Call 911
It is cold, and I begin to worry about him. I have never dealt with someone in this condition before. I don’t know what to do. He is sweating so much, I wonder if this might be an overdose. I don’t want him to die. I am in over my head here.
I don’t tell the dispatcher anything about drugs. I simply describe his condition and say I need assistance. Somehow by the time the paramedics arrive, I have convinced Luther to sit down at a table near the window inside. He keeps watching the cars and looking up and down the street, but he is at least seated.
The paramedics recognize drugs and they are immeasurably kind. One quietly asks Luther directly, “What are you on? What did you take?” and Luther answers straight-faced, “Crack cocaine, Sir.” I cringe at his automated response to a uniformed white man.
The paramedics take his blood pressure and measure his pulse. They ask him more questions, and then they tell him they would like to take him to the hospital where doctors can monitor him until he feels better. Luther says forcefully, “No. I don’t want to go to the hospital. I won’t go.” Again, they try to convince him to go, but he refuses. Calmly, but with eyes flashing, he tells them, “I’m not going to the hospital. The sister here will take care of me.”
The paramedics look at me, eyebrows raised. I look at them and then back at Luther. The one who has been so kind pulls me to the side and explains, “We cannot take him to the hospital if he is refusing to go.” I ask if Luther is in any danger. He tells me that because he is sweating so much, they are most concerned about dehydration and then hypothermia. I look back at Luther who still sits, a little calmer now, sweat still rolling off his nose, and I say, “Okay. I’ll take care of him, but I don’t know-how. You’ll have to tell me what to do.”
He tells me to give Luther water, lots of water. “Do your best to make him drink it. And make him walk. It’s important he keeps moving. It will help the drugs to move through his system more quickly. Make him walk and drink. Can you do that?”
Can I do that? How did I get here? I cannot count the times I have wondered this question. I tell the paramedic I will do my best and I thank him for his kindness to Luther. He promises they will sit outside in the ambulance until they receive another call to go. “If you need us, we’ll be right outside.”
Walking Together
Somehow, I help that big man to his feet and we start walking. My arm in his, my hand on his massive bicep, I lead him. We pace the room—back and forth, around the furniture, front to back. He holds the glass of water I hand to him. Every few minutes I push it toward his mouth, reminding him to drink. He talks and he talks. More and more makes sense. What had happened?
That morning, he had been watching the news when he saw a report of a robbery at a convenience store on the other side of town. Right there on the television, Luther saw the booking photo of his own teenage daughter. His big shoulders hunch, and holding his face in his hands he sobs as he tells me, “She’s on the same road I took. I wanted so much more for her. I tried. I was doin’ my best to show her I could do it. She didn’t have to go down the same road I did. But I couldn’t stop her. What’s the use? It don’t matter how hard you try. I said, ‘Fuck it,’ and I went and bought some shit.”
He talks. Then I talk. We cry together. And we walk. At some point, I notice the ambulance is gone. I don’t know what I am supposed to do next. How will I know when he is safe? How long does this kind of thing take?
Then Luther tells me, “I have a rock right here in my pocket.” “Cocaine? Right here? In your pocket? In Joe’s?” I talk with him about his future, about the choice he has in front of him. I speak hope. I speak plans and dreams. I acknowledge his failure but encourage him to get back up and start again. He becomes quiet. I hope he is listening. Finally, he says, “Let’s go to the bathroom and flush it right now.” I am thrilled. Victory.
As we walk through the door into our tiny bathroom, it crosses my mind this might not be the safest thing for me to be doing. There are other people in the shop, but they could never make it in time if he attacks me. There is no turning back now. We are there. I pray, “God, help me” (I had not stopped praying since the moment Luther walked in a couple of hours before). I want this. I want to be a part of helping this man flush his drugs, to start his life again.
In one swift and nimble motion, Luther pulls a loaded pipe from his pocket, puts it to his mouth, and clicks his lighter. He puffs two times, takes a deep breath, and leans his head back. I am confused. It happens so fast I’m not sure what is going on. Then suddenly I am overwhelmed with emotions. Anger replaces any fear I had. He has tricked me. He had no intention of flushing his drugs.
Autonomy
I step back from him and open the bathroom door. Standing in the doorway, I say, “If this is what you have decided to do, that is your choice, but you cannot do it here.” “Aww. Come on, sister.” “No. You cannot do this here.” He stands up, and for a moment I think, “Here it comes.”
Then he puts the pipe in his pocket. As he passes, he puts his hand on my shoulder and says, “Thank you for everything, sister. I love you.” He lumbers out of the bathroom, out the front door of Joe’s, down the sidewalk, down the street. I crumble to the floor and bawl.
I only see Luther once after this day, months later. He is downtown, miles away from Joe’s Addiction. He still towers above, but his muscles are gone. His skin hangs on his bones. He smiles and asks, “How you doin’, sister?” I tell him I am fine and ask how he is. He answers, “Well, you know.”
The day of Luther’s drug crisis, I cried out to God, “Don’t send me any more drug addicts, if you won’t send me help for them!”
Celebrate Recovery
Two weeks later, a lady calls me. She says she has heard about Joe’s Addiction and is a leader in a Celebrate Recovery group at a big Southern Baptist Church nearby. She wonders if we might need some help with addiction recovery.
The woman explains how the group works. She tells me about the materials and that they require the participants to purchase the books ($30/person). They would also need to come to the meetings once a week at their church. She says everyone is welcome, and they would love to have people from our Joe’s Addiction community attend.
I tell her I am grateful she has called and I believe she is the answer to my desperate prayers. I then explain to her that most of the people who need her program are living outside and have no means of transportation. It would be difficult for them to make it to a once a week meeting at their church. She responds, “Well, we’re only a few miles away from you. I’m sure they can walk if they’re serious about their recovery.” This church is an eight-mile-round-trip walk from us.
I then tell her, because most of them are unemployed, that they cannot afford the books the program requires. She explains it is an important piece of the program for the addicts to pay the cost. It provides accountability and tests their resolve. “I understand,” I tell her, “Truly I do. We agree. We do our best to help people help themselves, and we understand codependency and enabling.” I suggest perhaps they could reduce the cost. She responds that would be up to us. If we want to purchase books for our people and then offer them at a reduced rate, we can do that, “As long as you charge them something. It’s really important they pay for the materials themselves.”
I thank the woman for her offer and then I ask her, “Out of curiosity, are you an addict, ma’am. Are you in recovery?” She says, “Oh yes, I am. I am a recovering workaholic. One of the great things about CR is that it is open to people with any kind of addiction. It doesn’t just have to be substance abuse.”
I would like to be able to say I hung up the phone simply deflated, but that is not who I am. I was livid. I may have dropped a few F-bombs of my own. My addicted friends would rather use drugs than eat. Walk four miles each direction to attend a meeting? That’s not going to happen. A pack of cigarettes costs $4. There is no way they can stay sober without their cigarettes. Pay for recovery study books? Where would they store them even if they bought them? Keeping their clothing dry is a big enough task.
Narcotics Anonymous
We have since hosted Narcotics Anonymous meetings, but drug addiction continues to be one of our most difficult and frustrating challenges. It is hard for those of us who have not experienced addiction to empathize with the struggle. Judgment often shouts, “Just stop! Quit!” I have even heard a pastor say, “It’s not that hard to quit. Just don’t put it in your mouth.” The ironic thing is that this pastor was obese. I restrained myself, but I wanted to shout at him, “Just don’t put it in your mouth!” Addiction is a killer. If the substances don’t themselves do the killing, more often than not futility and shame do the job. The suffering is worse than any illness I have encountered.
What You Can Do
Express empathy. Accepting people as they are, frees them to change. Acceptance of the individual is not the same as an agreement with or approval of his or her behavior.
Motivation is a state, not a trait. We can influence a person’s motivation for change.
Resistance is not a force to be overcome.
Develop discrepancy. When a behavior is seen as conflicting with important personal goals, change is more likely to occur.
Ambivalence is a positive thing because it means people are wrestling with change.
The addicted is an ally, not an adversary.
Roll with resistance. Arguing is counterproductive; reluctance and ambivalence are natural and understandable.
Support self-efficacy. A person’s belief in the possibility of change can be an important motivator. Recovery and change are intrinsic to the human experience
